Background:A variety of ECG changes occur as an aftermath of stroke. Prolongation of the QTc interval is a well-documented change. We analyzed QTc interval prolongation among patients with acute hemorrhagic strokes.Methods:This observational study was conducted at the Emergency Department of Sulaymaniyah General Teaching Hospital and Shar Hospital from September 1st, 2014 to August 31st, 2015. Fifty patients who developed acute spontaneous hypertensive intracerebral hemorrhage (ICH) and 50 patients who developed acute non-traumatic subarachnoid hemorrhage (SAH) were included in the study. All patients underwent resting 12-lead ECG within half an hour of admission. The QTc interval was calculated and analyzed in those 100 patients.Results:Females (62%) outnumbered males (38%) with a female to male ratio of 1.6:1. Forty percent of the patients were between 60-69 years of age. Hypertension was seen in 82% of patients while left ventricular hypertrophy was documented in 40% of patients. The QTc was prolonged in 38 patients (17 patients in the ICH group and 21 patients in the SAH group). In both groups, males demonstrated QTc prolongation more than females. However, there were no statistically significant gender difference between both groups and within the same group. There was a statistically significant association between SAH and QTc prolongation (p-value<0.001); the ICH group did not demonstrate any significant relationship with QTc prolongation.Conclusion:Prolongation in the QTc interval was “statistically” associated with acute SAH only. No gender difference was noted; whether this observation is clinically significant or not, it needs further analytic studies.
Objective The role of ABO types and RhD antigen in coronavirus disease 2019 (COVID-19) severity has been investigated in several recent studies. Thus, the objective of this study was to identify the relationship of ABO and RhD types with symptomatic COVID-19 disease and determine the groups associated with an increased risk of hospitalization. Methods This observational case-control study was performed in 530 Iraqi-Kurdish patients with COVID-19. Among them, 184 were severe cases that required hospitalization, while 346 were mild to moderate cases that were treated at home. ABO and RhD antigen groups were compared between cases and 1698 control records from 1 year before the pandemic. The diagnosis of COVID-19 was based on real-time polymerase chain reaction tests and high-resolution chest computed tomography scans with the typical clinical presentation. Results There were no significant differences in ABO and RhD antigen distributions between the COVID-19 cases and non-COVID controls. No ABO group was associated with the risk of hospitalization as a marker of the severity of infection. Conclusions There was no significant association between symptomatic COVID-19 disease and any ABO group or RhD antigen type. No impact of ABO groups on hospitalization was documented.
Objective The long-term outcomes of primary carotid artery closure after carotid endarterectomy (CEA) have not been sufficiently studied. This prospective study was performed to analyze the 5-year outcomes of the non-shunting and primary arterial repair technique for CEA. Methods This study involved 150 patients who underwent CEA with the primary arterial closure technique without arterial shunting and completed 5 years of follow-up. Results The patients comprised 107 men and 43 women. The 30-day postoperative course was uneventful in 147 (98.0%) patients; however, cerebrovascular accidents occurred in 3 (2.0%) patients. With respect to the long-term results, most cases of restenosis at 5 years were <50%. Two patients developed asymptomatic total internal carotid artery occlusion. Eleven deaths occurred (mortality rate of 7.3%); one death (0.7%) occurred in the first 30 days. Conclusion Primary arteriotomy closure provides very good long-term patency. Routine use of patch closure is unnecessary.
Background Intracerebral haemorrhage (ICH) outcome depends on hematoma volume, location, and expansion. Objectives To assess the validity of neuroimaging signs for predicting the prognosis of patients with acute ICH in our population. Patients and Methods A prospective cohort study was performed on 90 patients with acute ICH admitted to Shar Hospital from March to October 2019. Inclusion criteria were ages of ≥18 years and spontaneous ICH, and exclusion criteria were trauma, brain tumour, and secondary ICH. Demographic features were recorded. Blackhole, swirl, island, Blend and spot signs, ICH location and volume, and ICH score were assessed by non-contrast computed tomography (CT) scan and CT angiography. Glasgow coma scale (GCS) and modified Rankin scale were used to assessing patients’ outcomes Results Except for the ages of patients (p-values=0.01), other demographic characteristics had no significant associations with the expansion of hematoma and outcome. Modified Rankin Scale, GCS, and hematoma location and volume had statistically significant associations with hematoma expansion and outcome. Further, strong sensitivity of black hole (90.9%) and spot (92.8%) signs, strong specificity of Blend (92.6%) and spot signs (97.1%), substantial positive predictive value for spot sign (92.8%), substantial negative predictive value was for all signs. In addition, substantial accuracy of spot sign (95.8%), were found. Also, significant associations for all the signs, except Blend, with hematoma expansion were found. Conclusion It is better to use neuroimaging signs, at least the signs found on non-contrast CT scans, all together in clinical practice.
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